Healthcare Provider Details

I. General information

NPI: 1467765073
Provider Name (Legal Business Name): RELIABLE D M E LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2010
Last Update Date: 08/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5117 E. HWY 83 STE. A
RIO GRANDE CITY TX
78582-6396
US

IV. Provider business mailing address

5117 E. HWY 83 STE. A
RIO GRANDE CITY TX
78582-6396
US

V. Phone/Fax

Practice location:
  • Phone: 956-487-2000
  • Fax: 956-487-2001
Mailing address:
  • Phone: 956-487-2000
  • Fax: 956-487-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSE ONELIO LEAL JR.
Title or Position: OWNER
Credential: LVN
Phone: 956-487-2000